clinical resource guide

Clinical Resource Guide

2021-2022

Pre-Licensure BSN Degree Program

AURORA CAMPUS

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Contents INTRODUCTION TO THE CLINICAL RESOURCE GUIDE ............................................................................................. 3

CastleBranch ........................................................................................................................................................ 3

Establish a CastleBranch Account ..................................................................................................................... 3

Accessing your Account .................................................................................................................................... 4

BACKGROUND CHECKS, FINGERPRINTING, AND DRUG SCREEN ........................................................................... 4

Background Check ................................................................................................................................................ 4

Fingerprinting ....................................................................................................................................................... 4

Additional Steps ............................................................................................................................................... 4

Drug Screen .......................................................................................................................................................... 5

Additional Steps ............................................................................................................................................... 5

MEDICAL DOCUMENT MANAGER ......................................................................................................................... 5

Establish a Medical Document Manager Account............................................................................................. 6

Immunizations ..................................................................................................................................................... 6

Tuberculin (TB) Test ............................................................................................................................................. 7

Certificate of Health Examination and Immunity Form ........................................................................................ 8

Proof of Health Insurance..................................................................................................................................... 8

American Heart Association Cardiopulmonary Resuscitation (CPR) Certification ................................................. 9

CORE PERFORMANCE STANDARDS....................................................................................................................... 9

HIPPA, OSHA & THE SON STUDENT HANDBOOK .................................................................................................... 9

MISCELLANEOUS ................................................................................................................................................... 9

Uniform Information ............................................................................................................................................. 9

Name Badge Information .................................................................................................................................... 10

Supplies for Clinical and Laboratory .................................................................................................................... 10

Appendix A ......................................................................................................................................................... 11

Deadlines & Fees for Clinical Requirements ..................................................................................................... 11

Appendix B ......................................................................................................................................................... 12

Submitting Documents .................................................................................................................................... 12

Appendix C ......................................................................................................................................................... 15

Core Performance Standards........................................................................................................................... 15

Appendix D ......................................................................................................................................................... 17

Name Badge Order Form................................................................................................................................. 17

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INTRODUCTION TO THE CLINICAL RESOURCE GUIDE Welcome as you embark upon this new journey as a nursing student in the Pre-licensure BSN Degree Program. Clinical rotations will begin during the first semester of your junior year and will provide you with the opportunity to learn and practice nursing skills. This Clinical Resource Guide provides you with information and clinical requirements you need to complete before starting the first semester. To participate and progress in clinicals, students must meet and maintain the necessary clinical requirements. You need to start completing these requirements TODAY to ensure they are completed on time. Students will NOT be allowed to participate in clinicals if ANY of the required documentation is not completed by the dates specified in Appendix A & uploaded to your CastleBranch account.

CastleBranch Our program uses CastleBranch services to ensure all students meet health care organizations, School of Nursing, and university requirements for Illinois. You will need to purchase TWO (2) CastleBranch packages, explained below. CastleBranch is a reputable, secure, online environment that the program uses to record and track the documents necessary for participation in clinicals. All expenses incurred for the background check, online document tracker, immunizations, physical examination, drug screening and tuberculin (TB) tests are the responsibility of the student. These requirements include the following:

• Background Check • Fingerprinting • Drug Screen • Immunization/TB test Tracking • Certificate of Health Examination • Proof of Health Insurance • CPR Certification • Core Performance Standards

Each of these will be explained in some detail; however, we welcome your questions as they arise. Requirements not documented in CastleBranch may be found under MISCELLANEOUS.

Establish a CastleBranch Account 1. Go to https://discover.castlebranch.com/ 2. Click on place order. 3. Enter the Aurora University Package Code UR36 4. Agree to terms and conditions and click continue 5. Provide the necessary information (i.e. name, date of birth, etc.) needed to complete your

background check. (order placement should be completed in one sitting to avoid any possible issues with orders not going through).

6. Select a form of payment. Payment is due at the time you place the order. 7. Cost is $153.00 (Background check, ISP-IL State Police-UCIA Applicant Fingerprinting, and

drug screen).

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Please note: Purchasing this package automatically starts the background check process. Additional steps are required for fingerprinting & the Drug Screen. Accessing your Account 1. Go to https://discover.castlebranch.com/ 2. Click on sign in, select MYCB 3. Log in using the email address you provided and password you created during order placement.

BACKGROUND CHECKS, FINGERPRINTING, AND DRUG SCREEN

Background Check Your CastleBranch account is established when you place your first order for the Background Check package. If you already have an account with CastleBranch from another school or organization, you will still need to purchase the Aurora University packages, as they specifically match our requirements and we cannot access accounts from other schools/organizations.

It is important to completely disclose all background information to the school and the healthcare setting, even for crimes that have been expunged. Failure to fully disclose and accept accountability may result in losing opportunities to participate in clinical. Any convictions found in your background check will be reviewed by the School of Nursing and forwarded to the clinical site. Flagged background checks will be reviewed individually; however, placement in clinical is not guaranteed. Each clinical facility determines if a student may participate in clinical. For details about convictions that may impact clinical placement, contact the School of Nursing at 630-844-5130. Please note that CastleBranch will not process an Illinois Statewide Criminal Search request before receiving the signed release form. The downloadable Illinois State Police release form and Child Abuse release form will be provided online during the ordering process. The applicant signed form can be faxed to 910.343.9731 or emailed to [email protected]

Fingerprinting All students are required to complete a fingerprint scan as part of the criteria for participating in clinical at health care facilities in Illinois.

Additional Steps 1. Register at www.ibtfingerprint.com to complete fingerprint scan. 2. Select IL, select digital fingerprinting and access the online scheduling link. 3. Application category: select UCIA Applicant from the Agency Name drop down box. 4. Employer category: select Aurora University-Nursing from the Employer Name drop

down box. 5. Select your appointment day and time.

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6. Payment method - purchasing the package includes payment for fingerprinting, you will receive the billing code within the tracker when you place your order-you do not pay the fingerprint facility when scanned

7. Print and bring confirmation form and valid driver’s license to the appointment. 8. Email your TCN receipt to Angie Alvarez: [email protected] 9. Results will be sent to Aurora University. 10. Eligibility for placement occurs AFTER fingerprint, background check & drug screen

results are received (may take 2-3 months).

Drug Screen A cleared drug screen will be posted to your CastleBranch account. If there are any issues with the drug test, CastleBranch will notify the student by email. The student will need to reach out to the MRO at 1-800-526-9341, to discuss the results and ask the student to provide documentation showing they have a prescription or had a procedure that would cause the results to show positive. After three (3) days CastleBranch will release the results to the School of Nursing.

Additional Steps 1. Go to https://mycb.castlebranch.com, login to your MYCB account, and click on “To Do”

list. The drug screen should appear in your list after you establish your account & purchase the Aurora University Package (see Establish a CastleBranch Account above).

2. Download and Print your drug test registration form. You will need to take this drug screen form to one of the Quest Diagnostics laboratories listed on CastleBranch, for specimen collection. Quest Diagnostics is the only acceptable laboratory that may be used for screening.

3. Bring a valid driver’s license to the laboratory on the day of specimen collection. 4. Results will be sent to CastleBranch in 3-5 business days. 5. CastleBranch posts results to your account.

MEDICAL DOCUMENT MANAGER Your required health information will need to be uploaded via Medical Document Manager (MDM) in CastleBranch. They will verify that the documents meet Aurora University’s School of Nursing requirements. If the documents do not, you will receive an email from CastleBranch. They will also send you a reminder if any of your documents will be expiring and if there is anything else needed to process the requirements. Your order will show as “In Process” until all requirements have been uploaded and approved. You likely will not receive notification from the School of Nursing if any of your documents are missing or incomplete, so it is imperative that you check your emails and access your MYCB account regularly so that you are aware of all requirements that need attention. You are not allowed to attend clinical with any expired requirements. The MDM is a separate package that you will need to purchase & is where you will upload the following information:

• Immunization/TB test Tracking • Certificate of Health Examination

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• Proof of Health Insurance • CPR Certification • Core Performance Standards

Establish a Medical Document Manager Account 1. Go to https://mycb.castlebranch.com 2. In the upper right hand corner, enter the package code: UR36im 3. Select a form of payment. Payment is due at the time you place the order. 4. Cost is $35.00 5. See Appendix B - Submitting Documents for instructions on how to upload health

information. Immunizations Students on clinical rotations in health care facilities are at higher risk than the general population for acquiring communicable diseases. Any student who has one of these diseases may, in turn, infect other personnel and clients/patients. Thus, healthcare facilities require evidence of immunization or natural immunity against those diseases that can be prevented. Student name MUST be listed on all pages of documents.

Documentation of receipt of the following immunizations must be completed by the dates specified in Appendix A. See your progression in the program

Appendix B – Submitting Documents for instructions on how to upload immunization information. A. Measles (Rubeola) – Titer to prove immunity. Report must include lab value with a

reference range. If negative (non-immune) or equivocal, repeat vaccine series per Center for Disease Control & Prevention (CDC) for Healthcare Workers guidelines. If positive, requirement is complete.

B. Mumps - Titer to prove immunity. Report must include lab value with a reference range. If negative (non-immune) or equivocal, repeat vaccine series per CDC for Healthcare Workers guidelines. If positive, requirement is complete.

C. Rubella - Titer to prove immunity. Report must include lab value with a reference range. If negative (non-immune) or equivocal, repeat vaccine series per CDC for Healthcare Workers guidelines. If positive, requirement is complete.

D. Hepatitis B – Titer to prove immunity. Report must include lab value with a reference range. If negative (non-immune) or equivocal, repeat vaccine series and repeat a titer in 1-2 months after dose #3 per CDC for Healthcare Workers guidelines. If positive, requirement is complete.

E. Varicella - Titer to prove immunity. Report must include lab value with a reference range. If negative (non-immune) or equivocal, repeat vaccine series per CDC for Healthcare Workers guidelines. If positive, requirement is complete.

F. Tetanus, Diphtheria & Pertussis (Tdap) - Must remain current (Vaccine every 10 years) for duration of the program. Booster may be Tdap or Td.

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G. Influenza - Must be completed annually. For fall admission applicants must get the current flu vaccine which is usually not available until mid-August. The flu shot must be completed between 8/15 and 10/15 for fall admission & between 9/1 and 12/1 for spring admission. It should include the following:

• Administration date • Name of facility (i.e., Walgreens Northwestern, Rush Copley) or name of who

administered vaccine (i.e., RN, MD) H. COVID-19 -Must upload proof of being fully vaccinated for COVID-19

I. Hepatitis A & Polio (Optional) - Document vaccine history

You MUST upload your titer results first, even if the results are negative. Once the results have been reviewed, a next step of “repeat vaccine series 1” will be generated for you to upload proof of having received the first vaccine. This will continue until the series is completed. You will ONLY need to repeat a titer for HEP B if you repeated the vaccine series.

Tuberculin (TB) Test Students must submit documentation of negative evidence of TB Test by dates specified in Appendix A- Deadlines & Fees for Clinical Requirements. All subsequent tests must be completed annually (every year) prior to expiration date. See Appendix B– Submitting Documents for instructions on how to upload immunization information. Student name MUST be listed on all pages of documents.

Acceptable negative evidence includes ONE of the following:

Initially (Upon Admission to the SON)

• 2-step TB skin test* • QuantiFeron Gold blood test • T-Spot test • IGRA blood test

Annually

• 1-step TB Test • QuantiFeron Gold blood test • T-Spot test • IGRA blood test

If positive TB test, you must have a chest-x-ray completed, clearance from a healthcare provider, and submit the symptom free TB questionnaire, which is available for download in the TB requirement in your CastleBranch account.

* Students should anticipate the following two-step process timeline: (Any interruption in this schedule will result in your having to restart the process from the beginning.)

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Visit 1, day 1 • The first test is given to the student and he/she is told to return in 48 to 72 hours for the test to be read.

Visit 2, days 2-3 • The first test is evaluated, measured, and interpreted. • If the first test is negative, the student is given an appointment to return for a second test in 7–21 days. • If the first test is positive, it indicates that the student is infected with TB. No further testing is indicated. The student is referred for a chest X-ray and will need to submit the symptom free TB questionnaire, which is available to download in CastleBranch. An asymptomatic student, whose chest X-ray indicates no active disease, may attend class/clinical.

Visit 3, days 7-21 • The second test will be given to all applicants/students whose first test was negative, using the alternate arm.

Visit 4, 48-72 hours after the second test • The second test is evaluated, measured, and interpreted. • If the second test is negative, the applicant/student is not infected. • If the second test is positive, it indicates that the applicant/student is infected with TB. No further testing is indicated. The applicant/student will be referred for a chest X-ray and will need to submit the symptom free TB questionnaire, which is available to download in CastleBranch. An asymptomatic applicant/student, whose chest X-ray indicates no active disease, may attend class/clinical. •

Certificate of Health Examination and Immunity Form Students must provide the School of Nursing Certificate of Health Examination and Immunity Form. The AU Wellness Center form is not acceptable. The School of Nursing form allows students to participate in classroom and clinical activities without restrictions. It prevents health concerns that may negatively affect patients. This must be completed within the past 6 months and by the date specified in Appendix A- Deadlines & Fees for Clinical Requirements. The required form can be found: *http://aurora.edu/documents/academics/nursing/certificate-health-exam-03162017.pdf

Please call TODAY to schedule your appointment to complete your health requirements. DO NOT WAIT!

Other physical assessment documents will not suffice for this requirement. The form must be completed in ink, include the student’s name and date of birth on each page, have a nurse practitioner/medical doctor/physician’s assistant signature on pages 4 and 5, and make sure that the Healthcare Practitioner Statement on page 4 is complete before uploading it to your CastleBranch account by the dates specified in Appendix A – Deadlines & Fees for Clinical Requirements. See your progression in the program Appendix B – Submitting Documents for instructions on how to upload the Certificate of Health Examination and Immunity Form. Proof of Health Insurance Students are required to maintain health insurance while in the program. If you are not covered by a health insurance policy, you must initiate your own policy. Acceptable proof of insurance includes the following:

• Copy of health insurance card, front and back, which includes & matches student’s last name .

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• Document from insurance company stating that student is covered under a health insurance policy.

• If your health insurance changes at any time in the program, you must contact CastleBranch to submit your new health insurance information within 2 weeks of change.

American Heart Association Cardiopulmonary Resuscitation (CPR) Certification Nursing students are required to be CPR certified for Basic Life Support (BLS) for the Healthcare Provider/AED (including infant, child, adult, cognitive content and skills performance) by the American Heart Association by the dates specified in Appendix A – Deadlines & Fees for Clinical Requirements. You must keep this certification current throughout your enrollment in the nursing program and upload renewal of your CPR card to CastleBranch, prior to expiration. American Red Cross & Online certification/re-certification are not acceptable. To find a course near you: https://cpr.heart.org/en/cpr-courses-and-kits/healthcare-professional/basic-life-support-bls-training See your progression in the program Appendix B - Submitting Documents for instructions on how to upload CPR information.

Please note: Uploaded information must include the front and back of the signed CPR card, except when submitting an e-card.

CORE PERFORMANCE STANDARDS In addition to the forms that must be submitted to CastleBranch, every student is required to read, sign, and upload a copy of Appendix C indicating that they have received a copy of the core performance standards and are responsible for meeting the requirements by the date specified in Appendix A – Deadlines & Fees for Clinical Requirements. See Appendix B – Submitting Documents for instructions on how to upload signed core performance standards document.

HIPPA, OSHA & THE SON STUDENT HANDBOOK Instructions on completing the following items will be given during the first week of class: Handbook acknowledgement, HIPAA Signature Document, HIPPA Certification, and OSHA Certification

MISCELLANEOUS Uniform Information Students are required to wear the School of Nursing uniform. You may purchase the uniform pieces at any uniform shop that carries the Cherokee Brand www.cherokeeuniforms.com

1. Navy Blue Cherokee snap front warm up jacket a. Women’s - ORDER CODE 4350 or WW 310 or CK370A b. Men’s – ORDER CODE WW 360

2. White Cherokee Scrub top a. Women’s scrub top – ORDER CODE 4700 b. Unisex scrub top – ORDER CODE 4777 or 4876 c. Men’s scrub top—ORDER CODE CK885 or WW 695

3. Navy Blue Cherokee Uniform pants or skirt

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a. Women’s pants – ORDER CODE 4101 or 4005 b. Men’s pants – ORDER CODE 4000 or 1022 c. Unisex pants – ORDER CODE 4100 or 4043 d. Women’s skirt - ORDER CODE CK505A

Other required uniform pieces (to be purchased on your own):

1. Nursing shoes: o Clean, white leather or vinyl shoes in good condition. o Minimal color logo is permissible. o Clogs, Crocs and sandals are not permitted. Shoes must have a back to them.

From the Aurora Campus University Bookstore you will purchase:

1. TWO (2) Aurora University School of Nursing Patches. One will be sewn on the right sleeve of the white scrub top, 2 inches above the bottom of the sleeve & the second will be sewn on the right sleeve of the Navy Blue Cherokee V-Neck cardigan warm-up jacket, 2 inches below the shoulder seam.

PLEASE ALLOW A MINIMUM OF 3 WEEKS FOR YOUR UNIFORM DELIVERY. DO NOT WAIT UNTIL CLASSES START TO ORDER OR YOU MAY NOT GET YOUR UNIFORM IN TIME. UNIFORMS ARE REQUIRED TO BE WORN BEGINNING THE FIRST DAY OF LABORATORY.

Name Badge Information Each student is required to wear an Aurora University or George Williams College of Aurora University name badge at all times in any clinical setting. No nicknames are allowed on the badges; i.e., Jennifer must be Jennifer not Jenny, Robert must be Robert not Bob. Name badges MUST be ordered through the School of Nursing. The name badge will have your first name and first initial of your last name (for example; Sally J.). See Appendix D

Aurora University School of Nursing

Name Badge Order Form Each student is required to wear an Aurora University or George Williams College of Aurora University name badge at all times in any clinical setting. No nicknames are allowed on the badge; i.e., Jennifer must be Jennifer not Jenny, Robert must be Robert not Bob. Name badges MUST be ordered through the School of Nursing by completing this form. Each student must order at least one name badge. Your name badge will display your first name and only the first initial of your last name. Please mail order form and payment to: Aurora University 347 S. Gladstone Ave. Aurora, IL 60506

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Attention: Student Accounts

Full payment must accompany orders. Checks or money orders should be made payable to Aurora University. You may contact Student Accounts at 630-844-5470 for credit card payments. In-person payments should be made in the Student Accounts Office, located on the first floor of Eckhart Hall.

Orders must be received by due date, as stated in Appendix A. ORDERS RECEIVED AFTER DUE DATE MUST INCLUDE AN ADDITIONAL $5 FOR SHIPPING CHARGES. I am attending: (please check one) Aurora Campus George Williams College Campus

Quantity

_______ Student name badge $8.00 each $_______

Add $5 if received after due date $_______ (fall entry-7/15; spring entry-11/15)

TOTAL $_______ Full Name (PLEASE PRINT) _________________________________________________

First Name Last Name Name on badge (PLEASE PRINT) ____________________________________________

First Name First initial of Last NameD – Name Badge Order Form. Supplies for Clinical and Laboratory The School of Nursing requires you to purchase the specific equipment listed below. The Aurora University Student Nurses Association provides you an opportunity to purchase equipment through Standris Medical Supply. Their instructions are listed in red below. You may also buy your supplies elsewhere. Students can place their order for the medical equipment listed below online through Standris at: https://www.standris.com/register.asp?cg=39

The approximate costs for the following items are listed below:

#053 5.5 Bandage Scissors $3.50 #220 Quicklite: Push Button Switch (Pen Light with Batteries) $5.95 Stethoscope-Recommend Littmann Classic II or III prices range $96.50 **Do not purchase Littmann Lightweight** #768 Adult BP cuff w/case $38.00 #621 Gait Belt $14.50 #7000 White coat Folding Clipboard, nursing edition (optional) $31.99 #500 Kelly Forceps or Hemostats (optional) $4.50

If you already have any of these items, you are NOT required to purchase new ones.

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Appendix A

Aurora University School of Nursing – Aurora Campus

Deadlines & Fees for Clinical Requirements

Instructions regarding each of these will be available at http://aurora.edu/nursingdocs

I. BACKGROUND INFORMATION CHECKLIST (Cost $188.00) ITEM DUE DATE FALL

ENTRY DUE DATE SPRING

ENTRY Fingerprinting 6/1 10/15

Background Check 6/1 10/15 Drug Screen 6/1 10/15

II. HEALTH INFORMATION CHECKLIST

ITEM DUE DATE FALL ENTRY

DUE DATE SPRING ENTRY

Purchase Medical Document Manager package

6/1 11/1

Certificate of Health Examination (physical)

7/1 11/15

Immunizations 7/1 11/15 Influenza Vaccine 10/15 12/1

TB test 7/1 11/15 Core Performance Standards 7/1 11/15

Please note: Students are responsible for all fees associated with meeting clinical requirements

III. OTHER INFORMATION CHECKLIST (Cost approx. $300) ITEM DUE DATE FALL

ENTRY DUE DATE SPRING

ENTRY CPR Certification 7/1 11/15

Proof of Health Insurance 7/1 11/15 Uniforms 7/15 12/1

Name badge 7/15 11/15 Equipment for Clinical & Laboratory 7/15 11/15

HIPPA, OSHA & HANDBOOK ACKNOWLEDGEMENT INSTRUCTIONS WILL BE PROVIDED DURING THE FIRST WEEK OF LAB AND IS DUE BY 9/1/21. IV. CLINICAL/LAB AND ATI FEES TO BE ADDED TO YOUR FALL TUITION BILL (Cost approx. $1480.00)

Failure to complete these requirements by the above stated due dates will jeopardize clinical placement and impact your progression in the program

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Appendix B


Submitting Documents

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Appendix C


Core Performance Standards Purpose: Students enrolled in the Bachelor of Science in Nursing (BSN) Program are required to complete experiences in a variety of clinical settings and environments. In accordance with the Americans with Disabilities Act (ADA, 1990; 2008) the School of Nursing has established the following core performance standards required of students in the BSN program.

Policy Statement: Nursing students must demonstrate, with or without reasonable accommodations to policies and practices, the ability to perform the Core Performance Standards listed below during their nursing education.

Core Performance Standards Issue Standard Examples of Necessary Activities

(Not All Inclusive) Critical Thinking Critical thinking ability for effective

clinical reasoning and clinical judgment consistent with level of educational preparation

Identify cause-effect relationship in clinical situations. Use of the scientific method in the development of patient care plans. Evaluation of the effectiveness of nursing interventions.

Professional Relationships

Interpersonal skills sufficient for professional interactions with a diverse population of individuals, families and groups.

Establishment of rapport with patients/clients and colleagues. Capacity to engage in successful conflict resolution. Peer accountability.

Communication Communication adeptness sufficient for verbal and written professional interactions.

Explanation of treatment procedures, initiation of health teaching. Documentation and interpretation of nursing actions and patient/client responses.

Mobility Physical abilities sufficient for movement from room to room and in small spaces.

Movement about patient’s room, work spaces and treatment areas. Administration of rescue procedures – cardiopulmonary resuscitation.

Motor Skills Gross and fine motor abilities sufficient for providing safe, effective nursing care.

Calibration and use of equipment. Therapeutic positioning of patients.

Hearing Auditory ability sufficient for monitoring and assessing health needs.

Ability to hear monitoring device alarm and other emergency signals. Ability to discern auscultatory sounds and cries for help.

Visual Visual ability sufficient for observation and assessment necessary in patient care.

Ability to observe patient’s condition and responses to treatments.

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Issue Standard Examples of Necessary Activities (Not All Inclusive)

Tactile Tactile ability sufficient for physical assessment.

Ability to palpitate in physical examinations and various therapeutic interventions.

Procedure: 1. The School of Nursing will consider for progression applicants who demonstrate the ability to learn and

perform the Core Performance Standards identified in this document. 2. The Nursing School must ensure the health, safety, and security of all clients/patients. 3. Eligibility to enter or continue in the program will be based on scholastic accomplishments, as well as

physical and emotional capacities to perform the core performance standards necessary to meet the requirements of the program’s curriculum.

4. The standards are used to assist each student in determining whether accommodations or modifications are necessary. The nursing program must determine whether accommodations can reasonably be made. Applicants and current students are responsible for making disabilities known and formally seeking accommodations. If a student believes that he or she cannot meet one or more of the standards without accommodations or modifications, the nursing program must determine, on an individual basis, whether the necessary accommodations or modifications can be made reasonably. Reasonable accommodation might include:

a. Assuring that facilities are readily accessible for use by individuals with disabilities b. Restructuring or altering clinical experiences c. Modifying academic program plans d. Modifying examinations including location, timing and testing conditions e. Giving supplementary learning materials f. Providing qualified readers or interpreters 5. Students are required to sign the following statement following admission to the nursing program and yearly,

or when a change has occurred in circumstances.

I, __________________, understand that I must demonstrate mastery of the core performance standards described above prior to graduation. If I have a disability and need an accommodation, I agree to provide appropriate documentation of the disability to the Aurora University Center for Disability Resources with a request specifying the desired accommodations. This request must be presented in a timely manner prior to the need for accommodation to permit the request to be processed by the Director of Student Disability Services in collaboration with the School of Nursing. The School of Nursing will determine if any recommended accommodation will fundamentally alter the Program of study. Signature ________________________ __________ Date _________________________________ Contact the School of Nursing at 630-844-5130 if you have any questions about the Core Performance Standards and requirements stated above. Questions regarding disability certification and/or requests for accommodation should be directed to the Center for Disability Resources at 630-844-5454. Aurora University is committed to prohibiting discrimination based on disability.

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Appendix D

Aurora University School of Nursing

Name Badge Order Form Each student is required to wear an Aurora University or George Williams College of Aurora University name badge at all times in any clinical setting. No nicknames are allowed on the badge; i.e., Jennifer must be Jennifer not Jenny, Robert must be Robert not Bob. Name badges MUST be ordered through the School of Nursing by completing this form. Each student must order at least one name badge. Your name badge will display your first name and only the first initial of your last name. Please mail order form and payment to: Aurora University 347 S. Gladstone Ave. Aurora, IL 60506 Attention: Student Accounts

Full payment must accompany orders. Checks or money orders should be made payable to Aurora University. You may contact Student Accounts at 630-844-5470 for credit card payments. In-person payments should be made in the Student Accounts Office, located on the first floor of Eckhart Hall.

Orders must be received by due date, as stated in Appendix A. ORDERS RECEIVED AFTER DUE DATE MUST INCLUDE AN ADDITIONAL $5 FOR SHIPPING CHARGES. I am attending: (please check one) Aurora Campus George Williams College Campus

Quantity

_______ Student name badge $8.00 each $_______

Add $5 if received after due date $_______ (fall entry-7/15; spring entry-11/15)

TOTAL $_______ Full Name (PLEASE PRINT) _________________________________________________

First Name Last Name Name on badge (PLEASE PRINT) ____________________________________________

First Name First initial of Last Name